How to start a skilled nursing facility in Utah

Utah requires a Nursing care facility license from Utah Department of Health and Human Services, Division of Licensing and Background Checks (DLBC) to operate a skilled nursing facility.

License required

Yes

License

Nursing care facility license

Issuing agency

Utah Department of Health and Human Services, Division of Licensing and Background Checks (DLBC)

Certificate of need

Required

Medicare certification

Separate from the state license. The state survey agency runs an unannounced standard health survey, a Life Safety Code survey and an emergency-preparedness survey against 42 CFR Part 483 Subpart B. For a Medicare SNF the state certifies and the CMS Location decides Medicare participation; for a Medicaid-only NF the state's certification is final and the state Medicaid agency decides participation.

Regulation

Utah Admin. Code R432-150; Utah Code 26B-2-202; Utah Code 26B-3-311 (Medicaid NF moratorium)

1. Apply to DLBC for a nursing care facility license under Utah Admin. Code R432-150
2. Pass licensure inspection
3. For Medicaid certification, new or expanded Medicaid nursing facility beds fall under the moratorium; request an exception under Utah Code 26B-3-311(5) or (7) using the Moratorium Exception Request Application, or transfer existing beds
4. Complete federal certification for Medicare/Medicaid

Program

Utah Medicaid (Utah Department of Health and Human Services, DHHS)

Enrollment portal

PRISM Provider Portal

Application fee

Under the federal rule (42 CFR 455.460), institutional providers pay the CMS application fee when they first enroll, re-enroll or revalidate. The fee is $750 for calendar year 2026. Individual physicians and non-physician practitioners do not pay it. A fee already paid to Medicare or to another state's Medicaid program counts. Utah DHHS's enrollment pages do not list a separate state fee.

Fingerprinting

Under federal rules (42 CFR 455.434 and 455.450), the state places provider types in 'limited', 'moderate' or 'high' risk levels. High-risk providers, and anyone who owns 5% or more of one, must submit fingerprints for a criminal background check. Utah DHHS's enrollment pages do not describe a separate state fingerprint process.

Site visit

Under federal rule (42 CFR 455.432), the state must visit moderate- and high-risk providers before and after enrollment. Every enrolled provider must allow unannounced on-site inspections. Utah DHHS's enrollment pages do not describe a separate state site visit process.

Revalidation

Federal rule (42 CFR 455.414) requires the state to revalidate every enrolled provider at least once every 5 years. Utah DHHS's become-a-provider page does not describe a separate state revalidation cycle.

Full Utah Medicaid enrollment guide →

For this business

Required (licensing source)

CON program

No

Agency

Utah Department of Health and Human Services, Division of Integrated Healthcare (Medicaid certification of nursing care facilities)

Moratoria

Medicaid reimbursement is limited to nursing care facility programs that were Medicaid-certified as of May 9, 2016, plus programs approved under Utah Code 26B-3-311(5) and (7). The division may not process new Medicaid certification applications or reinstate expired certifications except as §26B-3-311 allows. Since May 4, 2021, new ICF/IID beds may be Medicaid-certified only if the statewide ICF/IID Medicaid bed total does not rise (Utah Code 26B-3-310).

Utah certificate of need details →

State minimum wage

$7.25 an hour

Effective

2009-07-24

Scheduled increases

No scheduled change found in the official sources reviewed.

HCBS 80/20 rule

Federal baseline: 42 CFR 441.302(k) requires the state to show that each provider spends at least 80% of Medicaid payments for homemaker, home health aide and personal care services under 1915(c) waivers on direct care worker pay and benefits. Compliance starts 2030-07-09 (for managed care, the first rating period starting on or after that date); annual payment-adequacy reporting under 441.311(e) starts 2028-07-09. A state may set a lower share for state-defined small providers and exempt providers facing hardship, each only through a public notice-and-comment process. The eCFR text has not changed since 2024-07-09. No state-published 80/20 implementation step (small-provider criteria, hardship exemption or reporting guidance) was found for this state in the official sources reviewed.

Skilled nursing facilities — active organization NPIs (NPPES)

237 (as of Sep 13, 2026)

Medicare/Medicaid-certified nursing homes (CMS Care Compare)

97 (as of Aug 1, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

321,779 (as of Jun 1, 2026)

All Utah Skilled nursing Medicaid rates, ranked →